{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T22:09:40Z","timestamp":1773180580798,"version":"3.50.1"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T00:00:00Z","timestamp":1661731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K18681"],"award-info":[{"award-number":["19K18681"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Yolk sac tumor (YST) is a germ cell tumor that is generally associated with good prognosis in children. It has been recently reported that vaginal YSTs can be cured using chemotherapy alone. Thus, minimal invasiveness and function preservation are pre-requisites for surgical approaches. Herein, we report a case of vaginal YST that was resected in a function-preserving manner using a unique combination of surgical approaches.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>In a 9-month-old Asian female infant, a vaginal tumor was detected while investigating for vaginal bleeding. The patient was referred to our hospital, and the tumor was diagnosed as a YST after incisional biopsy. Six courses of carboplatin-based chemotherapy were administered. Contrary to the findings in previous reports, the tumor was chemo-resistant and surgical resection was required for the residual tumor. During surgery, we utilized laparoscopic and endoscopic procedures to ensure tumor-free surgical margins at the cervix, rectum, and lateral wall of the vagina. Additionally, the posterior sagittal approach was used to easily resect the tumor, and the vagina was reconstructed leaving only inconspicuous scars in the intergluteal cleft. No complications occurred postoperatively. Pathological examination of the surgical specimen revealed tumor-free surgical margins. The patient received four cycles of intensified chemotherapy before and after the surgery. The patient has been disease-free for 6\u00a0months now.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our combination of laparo\/endoscopic and posterior sagittal approach ensured a tumor-free macroscopic surgical margin with easier, cosmetically pleasing vaginal reconstruction, while preserving the anorectal and urinary functions. We believe that this approach could be utilized not only for vaginal YST, but also for any vaginal tumor, especially those arising from the posterior or lateral wall.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-022-01520-8","type":"journal-article","created":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T08:03:25Z","timestamp":1661760205000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Vaginal yolk sac tumor resected by a novel laparo\/endoscope-assisted posterior sagittal approach: a case report"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5443-0175","authenticated-orcid":false,"given":"Motohiro","family":"Kano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryoya","family":"Furugane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keita","family":"Hogetsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuji","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junnosuke","family":"Maniwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamotsu","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Hashizume","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teizaburo","family":"Mori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiichiro","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masataka","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Fujino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Kanamori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keita","family":"Terashima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimikazu","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Yoneda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,29]]},"reference":[{"key":"1520_CR1","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1053\/j.sempedsurg.2011.10.005","volume":"21","author":"FJ Rescorla","year":"2012","unstructured":"Rescorla FJ. Pediatric germ cell tumors. Semin Pediatr Surg. 2012;21:51\u201360.","journal-title":"Semin Pediatr Surg"},{"key":"1520_CR2","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/j.path.2019.01.005","volume":"12","author":"ED Euscher","year":"2019","unstructured":"Euscher ED. Germ cell tumors of the female genital tract. Surg Pathol Clin. 2019;12:621\u201349.","journal-title":"Surg Pathol Clin"},{"key":"1520_CR3","first-page":"793","volume-title":"Pizzo and Poplack\u2019s Pediatric Oncology","author":"AL Frazier","year":"2021","unstructured":"Frazier AL, Olson TA, Schneider DT, Amatruda JF. Germ cell tumor. In: Blaney SM, Helman LJ, Adamson PC, editors. Pizzo and Poplack\u2019s Pediatric Oncology. 8th ed. Philadelphia: Wolters Kluwer Health; 2021. p. 793\u2013810.","edition":"8"},{"key":"1520_CR4","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1200\/JCO.2014.58.3369","volume":"33","author":"AL Frazier","year":"2015","unstructured":"Frazier AL, Hale JP, Rodriguez-Galindo C, Dang H, Olson T, Murray MJ, et al. Revised risk classification for pediatric extracranial germ cell tumors based on 25 years of clinical trial data from the United Kingdom and United States. J Clin Oncol. 2015;33:195\u2013201.","journal-title":"J Clin Oncol"},{"key":"1520_CR5","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12957-017-1110-y","volume":"15","author":"G Yuan","year":"2017","unstructured":"Yuan G, Yao H, Li X, Li H, Wu L. Stage 1 embryonal rhabdomyosarcoma of the female genital tract: a retrospective clinical study of nine cases. World J Surg Oncol. 2017;15:42.","journal-title":"World J Surg Oncol"},{"key":"1520_CR6","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.jpag.2020.06.020","volume":"34","author":"AC Mayhew","year":"2021","unstructured":"Mayhew AC, Rytting H, Olson TA, Smith E, Childress KJ. Vaginal yolk sac tumor: a case series and review of the literature. J Pediatr Adolesc Gynecol. 2021;34:54\u201360.","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"1520_CR7","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28601","author":"TB Lautz","year":"2020","unstructured":"Lautz TB, Martelli H, Fuchs J, Chargari C, Smeulders N, Granberg CF, et al. Local treatment of rhabdomyosarcoma of the female genital tract: expert consensus from the Children\u2019s Oncology Group, the European Soft-Tissue Sarcoma Group, and the Cooperative Weichteilsarkom Studiengruppe. Pediatr Blood Cancer. 2020. https:\/\/doi.org\/10.1002\/pbc.28601.","journal-title":"Pediatr Blood Cancer"},{"key":"1520_CR8","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1016\/S0022-3468(96)90090-1","volume":"31","author":"AM Davidoff","year":"1996","unstructured":"Davidoff AM, Hebra A, Bunin N, Shochat SJ, Schnaufer L. Endodermal sinus tumor in children. J Pediatr Surg. 1996;31:1075\u20138 (discussion 1078-1079).","journal-title":"J Pediatr Surg"},{"key":"1520_CR9","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1016\/S0022-3468(82)80448-X","volume":"17","author":"A Pe\u00f1a","year":"1982","unstructured":"Pe\u00f1a A, Devries PA. Posterior sagittal anorectoplasty: important technical considerations and new applications. J Pediatr Surg. 1982;17:796\u2013811.","journal-title":"J Pediatr Surg"},{"key":"1520_CR10","doi-asserted-by":"publisher","first-page":"2558","DOI":"10.1002\/1097-0142(19850601)55:11<2558::AID-CNCR2820551107>3.0.CO;2-J","volume":"55","author":"LJ Copeland","year":"1985","unstructured":"Copeland LJ, Sneige N, Ordonez NG, Hancock KC, Gershenson DM, Saul PB, et al. Endodermal sinus tumor of the vagina and cervix. Cancer. 1985;55:2558\u201365.","journal-title":"Cancer"},{"key":"1520_CR11","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1016\/S0140-6736(99)05215-0","volume":"355","author":"C Mauz-K\u00f6rholz","year":"2000","unstructured":"Mauz-K\u00f6rholz C, Harms D, Calaminus G, G\u00f6bel U. Primary chemotherapy and conservative surgery for vaginal yolk-sac tumour. Maligne Keimzelltumoren Study Group. Lancet. 2000;355:625.","journal-title":"Lancet"},{"key":"1520_CR12","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1016\/j.jpag.2021.06.006","volume":"34","author":"G Torino","year":"2021","unstructured":"Torino G, Roberti A, Turra F, Donofrio V, Bifano D, Abate M, et al. Laparoscopic trachelectomy for cervix yolk sac tumor in 11-month-old girl: the youngest case. J Pediatr Adolesc Gynecol. 2021;34:872\u20135.","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"1520_CR13","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.ygyno.2004.12.050","volume":"97","author":"NR Abu-Rustum","year":"2005","unstructured":"Abu-Rustum NR, Su W, Levine DA, Boyd J, Sonoda Y, Laquaglia MP. Pediatric radical abdominal trachelectomy for cervical clear cell carcinoma: a novel surgical approach. Gynecol Oncol. 2005;97:296\u2013300.","journal-title":"Gynecol Oncol"},{"key":"1520_CR14","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.1016\/j.jpedsurg.2010.05.032","volume":"45","author":"FC Lester","year":"2010","unstructured":"Lester FC, Farmer DL, Rabban JT, Chen LM. Radical trachelectomy for clear cell carcinoma of the cervix in a 6-year old: a case report, review, and description of the surgical technique. J Pediatr Surg. 2010;45:E1-5.","journal-title":"J Pediatr Surg"},{"key":"1520_CR15","doi-asserted-by":"publisher","first-page":"1486","DOI":"10.1097\/AOG.0000000000002949","volume":"132","author":"T May","year":"2018","unstructured":"May T, Allen L, Hogen L, King C, Lorenzo AJ, Browne-Farmer C, et al. Laparoscopic radical trachelectomy for embryonal rhabdomyosarcoma of the cervix in a 2-year-old girl. Obstet Gynecol. 2018;132:1486\u201390.","journal-title":"Obstet Gynecol"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01520-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-022-01520-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01520-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,29]],"date-time":"2022-08-29T08:10:45Z","timestamp":1661760645000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-022-01520-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,29]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1520"],"URL":"https:\/\/doi.org\/10.1186\/s40792-022-01520-8","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,29]]},"assertion":[{"value":"20 June 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study followed the Japanese Government issued ethical guidelines for medical and biological research involving human subjects and the Declaration of Helsinki. The patient\u2019s parents consented to the publication of the study, and the institutional review board approved the publication of the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient\u2019s parents consented to the publication of this manuscript on behalf of her.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no conflict of interests to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"162"}}